Do Complementary Or Alternative Sleep Aids Work
There isn’t enough scientific evidence to say whether most complementary and alternative sleep aids help treat insomnia.
- Certain relaxation techniques may be safe and effective in treating long-term insomnia. These techniques include using music, meditation, and yoga to relax the mind and body before sleeping.
- Some dietary supplements also claim to help people sleep. Manufacturers may label dietary supplements like melatonin as a “natural” product. Most of these products have not been proven to help people with insomnia. Melatonin may be useful for treating short-term insomnia for shift workers or people who have jet lag, but you should probably not take it long-term.
The Food and Drug Administration does not regulate dietary supplements like vitamins, minerals, and herbs in the same way it regulates medicines. Use this Understanding Drug-Supplement Interactions tool to learn how dietary supplements may interact with the prescription and over-the-counter medicines you take.
Insomnia And Neurological Problems
Problems affecting the brain, including neurodegenerative and neurodevelopmental disorders, have been found to be associated with an elevated risk of insomnia.
Neurodegenerative disorders, such as dementia and Alzheimers dementia, can throw off a persons circadian rhythm and perception of daily cues that drive the sleep-wake cycle. Nighttime confusion can further worsen sleep quality.
Neurodevelopmental disorders like attention-deficit/hyperactivity disorder can cause hyperarousal that makes it hard for people to get the sleep they need. Sleeping problems are common for children with Autism Spectrum Disorder and may persist into adulthood.
What Prescription Medicines Treat Insomnia
Prescription medicines can help treat short-term or long-term insomnia. But your doctor or nurse may have you try first rather than medicine to treat insomnia.
The types of prescription medicines used to treat insomnia include and certain kinds of antidepressants. Prescription sleep medicines can have serious side effects, including sleepiness during the daytime and increased risk of falls for older adults., They can also affect women differently than men. In 2013, the Food and Drug Administration required drug companies to lower the recommended dose for women of certain prescription sleep medicines with zolpidem, because women’s bodies do not break down the medicine as quickly as men’s bodies do.
If you decide to use a prescription sleep medicine:
- Ask your doctor, nurse, or pharmacist about any warnings and potential side effects of the medicine.
- Take the medicine at the time of day your doctor tells you to.
- Do not drive or do other activities that require you to be alert and sober.
- Take only the amount of medicine prescribed by your doctor.
- Tell your doctor, nurse, or pharmacist about all other medicines you take, both over-the-counter and prescription.
- Do not drink alcohol.
- Do not take medicines that your doctor has not prescribed to you.
- Talk to your doctor or nurse if you want to stop using the sleep medicine. You need to stop taking some sleep medicines gradually .
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Establish A Set Routine
Sticking to a reliable sleep routine helps encourage sleep as well. A healthy bedtime routine includes following the same pattern prior to going to bed each night. This might entail taking a shower or a bath, getting in pajamas, having a cup of tea, doing some stretches, reading a book, and/or lighting a candle. Any activities that you find calming, centering, and/or restorative will work.
The key is to do the same sequence of relaxing activities before bed consistentlythat pattern can help set the stage for an easier time falling asleep.
Signs And Symptoms Of Insomnia
Determining if you have insomnia usually isnt difficult. In most cases, you know if youre not sleeping well. Most patients see me already knowing their diagnosis, Meskill says.
But there are also some people who may not be aware that they have insomnia. Its possible that these people have so much going on that they might perceive symptoms of daytime fatigue as a result of other chronic health conditions or a busy schedule, she says.
Taking 30 minutes or longer to fall asleep at night suggests you have insomnia, according to MedlinePlus. When it comes to middle of the night awakenings, most people have a few of those each night. But if yours last more than a few seconds or minutes that is, youre fully awake and cant get back to sleep thats indicative of insomnia, notes Johns Hopkins Medicine.
Waking up early in the morning before you intend to can also be a sign of insomnia.
Keep in mind that adults need seven or more hours of sleep each night. There are individual differences in sleep needs: some people need just seven hours to feel perfectly rested and others need closer to nine. And everyones going to have a poor night of sleep from time to time. But if youre waking up just four or five hours after going to bed often, thats a problem, says the Centers for Disease Control and Prevention .
In addition to having trouble falling asleep at night, staying asleep, or waking up too early in the morning, common insomnia symptoms include:
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Keep Sleep In Perspective
People who suffer from insomnia are normally frustrated or annoyed by it. Paradoxically, this emotional state contributes to keeping them awake, starting a vicious cycle. It helps to stop expecting a set amount of sleep every night. Having less sleep than youd like doesnt cause any harm. Allow yourself to fall short of the ideal without getting anxious about it.
Exercising To Reduce Stress
Studies have shown that exercise reduces stress. Exercise effectively reduces fatigue, improves sleep, enhances overall cognitive function such as alertness and concentration, decreases overall levels of tension, and improves self-esteem. Because many of these are depleted when an individual experiences chronic stress, exercise provides an ideal coping mechanism. Despite popular belief, it is not necessary for exercise to be routine or intense in order to reduce stress as little as five minutes of aerobic exercise can begin to stimulate anti-anxiety effects. Further, a 10-minute walk may have the same psychological benefits as a 45-minute workout, reinforcing the assertion that exercise in any amount or intensity will reduce stress.
The Lazarus and Folkman model suggests that external events create a form of pressure to achieve, engage in, or experience a stressful situation. Stress is not the external event itself, but rather an interpretation and response to the potential threat this is when the coping process begins.
There are various ways individuals deal with perceived threats that may be stressful. However, people have a tendency to respond to threats with a predominant coping style, in which they dismiss feelings, or manipulate the stressful situation.
Highly adaptive/active/problem-focused mechanisms
Mental inhibition/disavowal mechanisms
Suggested strategies to improve stress management include:
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How Is Insomnia Managed Or Treated
Short-term insomnia often gets better on its own. For chronic insomnia, your healthcare provider may recommend:
- Cognitive Behavioral Therapy for Insomnia: Therapy : CBT-I is a brief, structured intervention for insomnia that helps you identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep. Unlike sleeping pills, CBT-I helps you overcome the underlying causes of your sleep problems.
- Medications: Behavior and lifestyle changes can best help you improve your sleep over the long term. In some cases, though, taking sleeping pills for a short time can help you sleep. Doctors recommend taking sleep medicines only now and then or only for a short time. They are not the first choice for treating chronic insomnia.
What Is Insomnia Symptoms Causes Diagnosis Treatment And Prevention
You know how awful one night of bad sleep can make you feel. Now multiply that one bad night by weeks, even months, and its easy to understand why insomnia can take a tremendous mental and physical toll on people.
If you struggle to sleep, youre not alone. Estimates suggest approximately 10 percent of adults suffer from chronic insomnia and between 15 and 35 percent of adults suffer from some level of short-term insomnia lasting anywhere from a few days to up to three months, according to the American Academy of Sleep Medicine.
Epidemiological studies show that lack of sleep is associated with obesity, diabetes, and heart disease, even Alzheimers, says Sara Nowakowski, PhD, a clinical psychologist and sleep researcher at the University of Texas Medical Branch in Galveston. Other consequences of insomnia include increased risk for psychiatric disorders and motor vehicle accidents. When it comes to health, she adds: Sleep is just as important as diet and other lifestyle behaviors.
Thats why dealing with insomnia and getting the help you need is critical. So how do you know if you have insomnia, and how do you treat it if you do have it? Read on to get answers to your most pressing questions.
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Why Is Sleep Important
Sleep is essential for good health. During sleep, our bodies and brains repair themselves. Some research suggests our brains use the time during sleep to clear away toxins that build up during the day. Sleep is also important to our ability to learn and form memories. Not getting enough sleep puts people at risk for health problems, including high blood pressure, obesity, and depression.
Insomnia Causes And Symptoms
Insomnia is believed to originate due to a state of hyperarousal that can impact sleep-onset and sleep maintenance. Hyperarousal can be mental, physical, or a combination of both. Environmental, physiological, and psychological factors can all play a role in insomnia. These include the following:
Insomnia has also been linked to unhealthy lifestyle and sleep habits. Many people adopt these habits when they are younger, making them hard to break as adults. These habits can include going to bed at a different time each night or napping too long during the day. Exposure to screen devices like computers, televisions, and cell phones can also cause sleep problems, as can working evening or night shifts. Other factors can cause difficulty falling or staying asleep, such as inadequate exercise during the day or excessive noise and/or light in the sleepers bedroom.
The most common symptoms among chronic insomnia patients include difficulty falling and/or staying asleep, waking up earlier than planned, and not feeling tired or ready for bed at scheduled times. Daytime impairment is a necessary component of insomnia, and this can also manifest in different ways. Common impairments include fatigue and malaise, memory and concentration difficulties, mood disturbances and irritability, and behavioral problems such as hyperactivity and aggression.
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What Are The Symptoms Of Insomnia How Is Insomnia Diagnosed
The symptoms of insomnia include:
difficulty falling asleep at night
waking up in the middle of the night
waking up too early
Not feeling well-rested after a night’s sleep
daytime tiredness or sleepiness
difficulty paying attention, focusing on tasks or remembering
increased errors or accidents in daily life
ongoing worries about sleep
The Stimulus Control Model
The stimulus control model was developed in 1972 by a scientist called Bootzin. The model focuses on the stimulus in our environment which can disturb our sleep, for example behaviours we engage in within the bedroom area which are not sleep related, such as working in the bedroom or watching TV. We then become accustomed to being awake in the bedroom, rather than associating it with sleep, which keeps the cycle of insomnia going.
This article explains that within this model, Sleep is viewed, in part, a conditioned response to the stimulus of the sleep environment. In insomnia, the bed/ sleep environment instead become stimuli for increased arousal, frustration, and wakefulness.
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Insomnia And Irregular Sleep Schedules
In an ideal world, the bodys internal clock, known as its circadian rhythm, closely follows the daily pattern of day and night. In reality, many people have sleep schedules that cause misalignment of their circadian rhythm.
Two well-known examples are jet lag and shift work. Jet lag disturbs sleep because a persons body cant adjust to a rapid change in time zone. Shift work requires a person to work through the night and sleep during the day. Both can give rise to a disrupted circadian rhythm and insomnia.
In some people, circadian rhythms can be shifted forward or backward without a clear cause, resulting in persistent difficulties in sleep timing and overall sleep quality.
Cause: Medical And Psychological Conditions
As discussed above, trouble sleeping can worsen other medical and emotional problems. But the opposite is also true – some health problems, both medical and mental health, can cause or worsen insomnia.
Painful conditions make it difficult to sleep.
Musculoskeletal conditions like arthritis and fibromyalgia often interfere with sleep. The pain associated with conditions makes it difficult to relax and get comfortable.
Gastrointestinal conditions also cause problems with sleep. It is common for the symptoms of gastroesophageal reflux, such as heartburn, to be worse when lying down, thus keeping a person awake.
People with trouble controlling their urine , as well as other urinary tract problems, often have their sleep disrupted. They may wake to find they have lost bladder control or they may wake a lot with the need to urinate.
Shortness of breath, chest congestion, and coughing occur with conditions like asthma, chronic obstructive pulmonary disease , and heart failure. Lying down to sleep makes it more difficult to breathe and often worsens coughing. Many people with these conditions have insomnia.
Trouble sleeping is a symptom of depression, anxiety disorder, and substance abuse. A person with any of these conditions will often have insomnia. When the disorders are treated, sleeping often improves.
Anxiety and Stress
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Applications To Mood Disorders
Psychiatric , such as and , are intertwined with . This is evident in the high rate of comorbidity with psychiatric disorders and insomnia and other sleep disorders. Most people with psychiatric diagnoses have significantly reduced sleep efficiency and total sleep time compared to controls. Thus it is not surprising that treating insomnia with CBT-I can help to improve mood disorders. A study in 2008 showed that augmenting with CBT-I in patients with major depressive disorder and comorbid insomnia helped to alleviate symptoms for both disorders. The overlap between mood- and sleep disorders is just starting to be rigorously explored, but the efficacy of CBT-I for major depressive disorder and bipolar disorder looks promising.
How Much Sleep Do Most People Need
Most adults need around seven to nine hours of sleep per night but the amount of sleep needed to function at your best varies between individuals. The quality of your rest matters just as much as the quantity. Tossing and turning and repeatedly awakening is as bad for your health as being unable to fall asleep.
What Are The Causes Of Insomnia
- Adjustment insomnia
- Sleep-restriction therapy
Sleep hygiene educationAddresses behaviors that are incompatible with sleep such as caffeine or alcohol use, environmental noise, inappropriate room temperature, and watching TV in bed.
Cognitive therapy and relaxation therapy
- Correct inaccurate beliefs about sleep
- Reduce fear and excessive worrying
- Relaxation therapy: The patient is advised to recognize and control tension through a series of exercises that consist of first tensing and then systematically relaxing each muscle group.
- Guided imagery and meditation to focus on neutral or pleasant thoughts
Stimulus-control therapyWorks by associating the bed with sleepiness instead of arousal. Rules for this therapy include:
- Use the bed only for sleeping and sexual activity .
- Go to bed only when sleepy.
- If unable to fall asleep in 15-20 minutes, get out of bed to do something relaxing until sleepy this can be repeated as often as needed.
- Do not spend more time in bed than needed.
- Establish a standard wake-up time.
- Avoid daytime napping.
- Sleep-restriction therapy is based on the fact that excessive time in bed can lead to insomnia. Limiting the time spent in bed leads to more efficient sleep.
- Works by limiting time in bed to the patients estimated total sleep time and increasing it by 15-30 minutes for a given week period until the optimal sleep duration is achieved.
Medication to treat insomnia
Associations Of Insomnia With Depression And Anxiety
Insomnia is known to be associated with depression and anxiety. What remains unknown is the nature of the association. For example, insomnia may presage the development of an incipient mood disorder, or mood disorders may independently predispose to insomnia.
In an early study of the association between insomnia and depression and anxiety, Ford and Kamerow found that after adjusting for medical disorders, ethnicity, and sex, patients with insomnia were 9.8 times more likely to have clinically significant depression and 17.3 times more likely to have clinically significant anxiety than persons without insomnia. A meta-analysis by Baglioni et al concluded that in nondepressed people with insomnia, the risk of developing depression is twice as high as in people without sleep difficulties.
Ohayon and Roth found that symptoms of insomnia were reported to occur before the first episode of an anxiety disorder 18% of the time simultaneously 39% of the time and after the onset of an anxiety disorder 44% of the time. In addition, insomnia symptoms were reported to occur before the first episode of a mood disorder 41% of the time simultaneously 29% of the time and after the onset of a mood disorder 29% of the time.
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